Women who are addicted to heroin are often given methadone, a synthetic narcotic, to take instead of heroin. Methadone withdrawal is probably the most common withdrawal seen in newborns, according to Marvin Wang, M.D. Mothers who take methadone in pregnancy will give birth to an addicted baby in 55 to 94 percent of cases, according to the American Academy of Pediatrics (AAP).
Central Nervous System Symptoms
Babies born addicted to methadone will go through withdrawal after delivery, usually within 24 to 48 hours, but possibly not for as long as 3 weeks, according to Dr. Wang, since methadone has a longer half life than other opiates. According to the AAP, newborns undergoing withdrawal from opiates and synthetic narcotics such as methadone are classified as having Neonatal Abstinence Syndrome, or NAS.
CNS symptoms of NAS include irritability, shrill cry, increased startle reflex and Moro reflex and increased muscle tone. Newborns with CNS symptoms may also be jittery, have fluctuating muscle tone, sleep less than normal and be easily disturbed by outside stimuli. Some infants, 2 to 11 percent, according to a report by DA Osborn entitled "Sedatives for Opiate Withdrawal in Newborn Infants," will have seizures from withdrawal.
Gastrointestinal Symptoms
NAS symptoms that affect the gastrointestinal system are poor feeding, increased need for sucking, poor suck-swallow coordination, dehydration, poor weight gain, and vomiting and watery stools, according to the AAP.
Respiratory Symptoms
Respiratory symptoms of NAS include tachypnea, or rapid breathing, frequent sneezing or yawning, stuffy nose and nasal flaring, according to the AAP.
Other Symptoms
Other symptoms of NAS include temperature instability or fever, skin mottling, increased sweating, and excoriation of extremities from increased restless movement, according to the AAP. The risk of SIDS is reported to be slightly higher in addicted infants than in the general population, but still less than 10 in 1,000, according to the Merck Manual for Healthcare Professionals.
NAS Scoring of Symptoms
Many hospitals assess the severity of symptoms and titrate medication doses based on NAS, or Neonatal Abstinence Scoring, which was developed by Loretta Finnegan in 1975. The NAS system assigns point values to different symptoms. The added totals give a score, which neonatal units use as a basis for medication decisions.
References
- "Perinatal Drug Abuse and Neonatal Drug Withdrawal;" Marvin Wang, MD; Clinical Instructor Dept. of Pediatrics, Harvard University; 2009
- American Academy of Pediatrics: Neonatal Drug WithdrawalPolicy Statement
- Merck Manual Online Medical Library for Helathcare Professionals; Prenatal Drug Exposure; 2005
